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Papers by Iwona Sadowska-Krawczenko
Journal of neonatal-perinatal medicine, Aug 16, 2023
Thrombosis Research, May 1, 2017
Fig. 1. The levels of MPs-TF (1A) and total TF (1B) in the cord blood of preterm infants (n = 23)... more Fig. 1. The levels of MPs-TF (1A) and total TF (1B) in the cord blood of preterm infants (n = 23) and term infants (n = 25).
Archives of Medical Science, 2012
Introduction: Healthcare-associated infection is a common problem in patients from neonatal inten... more Introduction: Healthcare-associated infection is a common problem in patients from neonatal intensive care units and it is one of the leading causes of death in this group of patients. Healthcare-associated infections are associated with increases in mortality, morbidity, and prolonged length of hospital stay. The aim of the study was to assess the incidence, clinical presentation, mortality and aetiology of healthcare-associated infections in newborns in a neonatal intensive care unit between 2005 and 2010. Material and methods: The research involved documentation of 2610 neonates hospitalized in this period in the Neonatal Intensive Care Unit, Dr Jan Biziel University Hospital No. 2 in Bydgoszcz. The incidence, clinical presentation, mortality and causative factors of healthcare-associated infections were assessed. Results: The prevalence of healthcare-associated infections was 7.32%. The most frequent healthcare-associated infections were bloodstream infection (65.4%) and urinary tract infection (22.5%). The mortality rate was 2.1%. The most frequent pathogens were coagulase-negative staphylococci (36.1%) and Klebsiella pneumoniae (29.3%). Conclusions: The rate of healthcare-associated bloodstream infections in the analysed department is low, taking into consideration the specificity of the department. There is a necessity to establish convenient definitions of various kinds of healthcare-associated infecions in neonates, especially those born preterm.
Medical Science Monitor, May 20, 2004
ABSTRACT Med Sci Monit, 2004; 10(Suppl 2): 112-114 112 BACKGROUND Aplasia cutis congenita (ACC) i... more ABSTRACT Med Sci Monit, 2004; 10(Suppl 2): 112-114 112 BACKGROUND Aplasia cutis congenita (ACC) is a rare disorder affecting 1–2 infants in every 10 000 births [1,2], characterized by the localized absence of all skin layers. The defect may also involve deeper tissues such as muscle and bone, often extending to the dura mater when the scalp is involved. The lesion is usually well demarcated, ulcerat-ed, and often presents as a translucent membrane beneath which underlying structures and vasculature can easily be visualized. The defect may also heal in utero, presenting as an atrophic scar at birth [3]. The majority of cases affect the scalp, but involvement of the trunk and extremities has been described. The disease may be isolated or associated with anom-alies of eyes, ear-nose-neck and limbs, developmental defects of the cardiovascular, gastrointestinal, genitouri-nary and central nervous systems, and malformation syndromes such as chromosomal abnormalities, Adams-Oliver syndrome, Bart's syndrome. Histological examination demonstrates a congenital absence of all skin layers, which are replaced by a layer of thin compact dermal collagen without overlying epithelium or adnexal structures. The most common complication related to this disorder are infection, haemorrhage, and, in defects localized on the vertex, meningitis and bleeding from the sagittal sinus. Therefore, when the defect is large, it is important to ensure a proper skin repair in order to avoid complica-tions and to prevent problems with thermoregulation and fluid balance. Healing of small size defects occurs with gradual epithelization from the margins, while a large loss of substance represents a major challenge, as healing can be slow and difficult as the aesthetic sequel can represent a relevant problem for the future of the patient. This case describes an otherwise healthy infant born of an initially twin gestation with a truncal and scalp cutis aplasia defect in an infant. CASE STUDY A 3500 g boy was born to a 27-year-old, insulin-depen-dent gestational diabetic woman who had received good prenatal care. The boy was born at 40 weeks' gestation by vaginal delivery and had an Apgar score of 8. The pregnancy was complicated by the death of a twin in the 16 th week of gestation. At birth, the boy was noted to have large skin defects on both sides of the abdominal wall (Figure 1), single lesion on the scalp (Figure 2) and two small defects on the both scapula region (Figure 3). Summary Background: Aplasia cutis congenital (ACC) is a rare group of disorders characterized by the focal absence of the skin recognized at birth.
Pediatria polska, Mar 1, 2012
STRESZCZENIE Wprowadzenie. Dane dostÚpne w piĂmiennictwie wskazujÈ, ĝe w zapobieganiu martwiczemu... more STRESZCZENIE Wprowadzenie. Dane dostÚpne w piĂmiennictwie wskazujÈ, ĝe w zapobieganiu martwiczemu zapaleniu jelit (NEC) pomocne mogÈ byÊ probiotyki. SkutecznoĂÊ kaĝdego szczepu probiotycznego musi byÊ oceniania oddzielnie. Cel. Ocena skutecznoĂci Lactobacillus rhamnosus ATC A07FA (L. rhamnosus), w porównaniu z placebo, w zapobieganiu NEC t2. stopnia wg Bella u wczeĂniaków z bardzo maïÈ urodzeniowÈ masÈ ciaïa. Metodyka. Przeprowadzono badanie z randomizacjÈ, metodÈ podwójnie Ălepej próby. WczeĂniaki speïniajÈce wszystkie kryteria wïÈczenia (wiek ciÈĝowy poniĝej 32. tygodnia, urodzeniowa masa ciaïa poniĝej 1500 g, czÚĂciowe lub caïkowite ĝywienie enteralne pokarmem matki) losowo przydzielano do jednej z 2 grup, w których otrzymywaïy L. rhamnosus (komerycyjnie dostÚpny jako preparat Lakcid) w dawce 1,2x10 10 jednostek tworzÈcych kolonie (n=30) albo placebo (n=25). InterwencjÚ rozpoczynano wraz z wprowadzeniem ĝywienia enteralnego, nie wczeĂniej niĝ w 7. dobie ĝycia, i stosowano przez caïy okres hospitalizacji. Gïównymi punktami koñcowymi byïy: NEC t2. stopnia wg Bella, posocznica oraz zgon. Wyniki. Badanie zostaïo ukoñczone przedwczeĂnie ze wzglÚdu na problemy z rekrutacjÈ. AnalizÈ objÚto dane doty-czÈce 55 wczeĂniaków. W grupie eksperymentalnej, w porównaniu z grupÈ kontrolnÈ, stwierdzono mniejsze ryzyko wystÈpienia NEC t2. stopnia wg Bella, ale róĝnica nie byïa istotna statystycznie (1/30; 3,3% versus 4/25; 16%, ryzyko wzglÚdne 0,2; 95% przedziaï ufnoĂci 0,02 do 1,75). W obu grupach stwierdzono podobne ryzyko posocznicy i zgonu. Nie stwierdzono istotnych statystycznie róĝnic pomiÚdzy grupami w zakresie wtórnych punktów koñcowych. Nie obserwowano dziaïañ niepoĝÈdanych. Wnioski. W chwili obecnej nie ma podstaw naukowych do stosowania L. rhamnosus ATC A07FA w zapobieganiu NEC u wczeĂniaków. Uzasadnione wydaje siÚ jednak przeprowadzenie badania z ww. szczepem, obejmujÈcego wiÚkszÈ liczbÚ wczeĂniaków.
Beneficial Microbes, Dec 1, 2014
A disseminated Lactobacillus rhamnosus GG ATCC 53103 infection was suspected in a 6 day-old newbo... more A disseminated Lactobacillus rhamnosus GG ATCC 53103 infection was suspected in a 6 day-old newborn with intrauterine growth restriction (IUGR) symptoms, treated empirically with antibiotics and given L. rhamnosus GG with the aim of preventing antibiotic-associated gastrointestinal complications. The level of C-reactive protein on day 5 compared with day 2 was increased in spite of negative urine and cerebrospinal fluid cultures. The blood sampled on day 6 was found to be positive for lactobacilli, and the isolate was pre-identified as L. rhamnosus or Lactobacillus casei on day 11. The strain identity was then verified as L. rhamnosus GG through PCR and 16S rRNA sequencing. Genotyping with the rep-PCR and AFLP methods confirmed the 100% genetic similarity for both the strain isolated from patient blood and the probiotic product. The newborn became touch-sensitive, cried a lot, had worsening laboratory test results, and increased inflammation parameters, but no fever was observed. After a further 9 days of antibiotic therapy, blood cultures became negative, and laboratory tests improved on day 25. The patient was discharged from the hospital after 27 days. IUGR with a possible link to L. rhamnosus GG bacteraemia might be a new potential risk group, beside patients with organ failure, immunocompromised status and dysfunctional gut barrier mechanisms, for which safe use of probiotics needs careful attention. Universally accepted or improved guidelines for the safer administration of probiotics in risk groups are urgently needed. This report should not discourage the use of probiotics, but should highlight the need for their careful use in IUGR patients.
Medical and Biological Sciences, 2012
Aim. Assessment of quality of life of children, adolescents and adults suffering from cystic fibr... more Aim. Assessment of quality of life of children, adolescents and adults suffering from cystic fibrosis and of their parents. Methods. Examination involved 23 persons (16 patients and 7 parents). Questionnaires CDQ-12-13, CFQ-14 and CFQ-6-13 were used as research tools. Results. Children between 12 and 13 years old, as well as young adults and adolescents ranked their physical aptitude and their food-related behaviours as highest, and the appearance of their bodies as lowest. Parents, on the other hand, assessed eating as a difficult effort for their children. A decisive majority of the parents claimed, that everyday therapy was time-consuming, yet fulfilling the therapy recommendations was not intensely difficult for the child. Also for adolescents and young adults, only minimally do the limitations resulting from a prolonged systematic therapy obstruct everyday life. Conclusion. The assessment of quality of life of children suffering from cystic fibrosis is varied. The highest patients' quality of life assessment is found in schoolchildren aged 12 to 13. Patients assess their body image as very poor.
PubMed, Apr 26, 2005
The aim of the study: Preliminary assessment of the incidence of acid gastroesophageal reflux in ... more The aim of the study: Preliminary assessment of the incidence of acid gastroesophageal reflux in preterm neonates with and without antenatal administration of steroids. Material and methods: Analysis of 96 neonates born before 34 weeks of pregnancy was undertaken. The patients were divided into two groups: I - those who received antenatal corticosteroids n=22; II - those who received no antenatal corticosteroids n=74. All patients had 24-hour pH-metry and basing on the result of this examination we diagnosed or excluded acid gastroesophageal reflux. Results: In group I gastroesophageal reflux was diagnosed in 9/22 neonates (40.9%), in group II in 12/72 (16.2%), odds ratio=3.58. Conclusions: The frequency of acid gastroesophageal reflux is higher in preterm infants who received antenatal corticosteroids.
Klinische Padiatrie, Dec 13, 2022
Medycyna wieku rozwojowego, Jul 1, 2005
Intrauterine growth retardation (IUGR) and prematurity are often correlated with higher mortality... more Intrauterine growth retardation (IUGR) and prematurity are often correlated with higher mortality and morbidity in the first days of life especially due to complications such as: hypoglycemia, polycythemia, necrotizing enterocolitis, meconium aspiration syndrome. Disturbances in the haemostatic system could be responsible for poor outcome of these complications. Aim: To determine the activity of main inhibitor of coagulation-antithrombin, level of protein C, concentration of thrombin-antithrombin (TAT) complexes and fibrinogen in the blood of premature infants with intrauterine growth retardation (IUGR) in comparison with premature infants without IUGR. Material: 33 premature infants with symptoms of intrauterine growth retardation (IUGR) and 146 premature infants without IUGR were included in our trial. Results: There were no statistical differences between the analyzed groups in the level of protein C, concentration of TAT and fibrinogen. Activity of antithrombin was higher within 1 hour after birth and lower on the third day of life in the group of children with IUGR. Conclusions: Higher activity of antithrombin after birth in the group of newborns with IUGR prevents excessive activation of coagulation. On the third or fourth day of life the activity of antithrombin decreases due to its higher consumption in the blood of newborns with IUGR.
Medycyna wieku rozwojowego, Jul 1, 2005
AIM OF THIS PAPER: To present the opinions of doctors and nurses on the limitations of resuscitat... more AIM OF THIS PAPER: To present the opinions of doctors and nurses on the limitations of resuscitation and treatment of extremely premature newborns. Material and methods: Anonymous questionnaire studies were carried out in 342 doctors and 1194 nurses from 6 provinces of Poland. The authors compared the answers of doctors and nurses as well as the answers form different provinces. The results were processed using the Chi2 test, with the significance level p<0.05. Results: The will to resuscitate the neonate, regardless of its birth weight was declared by 29% of the physicians and 49% of the nurses, regardless of the gestational age - by 21% of the physicians and 47% of the nurses. Resuscitation of an extremely immature, asphyctic newborn was declared by 71% of the physicians and 59% of the nurses. Limitation of therapy after diagnosing severe intracranial hemorrhage is declared by 67% of the physicians and 45% of the nurses. 37% of the doctors and 30% of the nurses would comply with parents' will when deciding about resuscitation. 44% of the physicians and 31% of the nurses declare taking parents' decision into account in the matter of abandoning resuscitation. Conclusions: 1. There is a higher percentage of persons convinced about the necessity of resuscitation of every newborn, regardless of its maturity, among the nurses than among the doctors. 2. Among the nurses there are more persons, who are sceptical about saving the extremely premature newborns born with asphyxia, whereas among the doctors there are more persons inclined to stop therapy in case of a severe intracranial hemorrhage. 3. The most controversial are problems concerning the consideration of parents' will in decision about whether to continue or abandon resuscitation, but physicians are more apt to regard parents' will in resuscitation in some situations. 4. The analysis of the questionnaire points to the need for deeper knowledge of the present mortality rates of the extremely immature newborns and further development of the surviving ones among the physicians and nurses.
Klinische Padiatrie, Nov 29, 2022
This is an open access article published by Thieme under the terms of the Creative Commons Attrib... more This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.
New England Journal of Medicine
Frontiers in Pediatrics
BackgroundTransient tachypnea of the newborn (TTN), which results from inadequate absorption of f... more BackgroundTransient tachypnea of the newborn (TTN), which results from inadequate absorption of fetal lung fluid, is the most common cause of neonatal respiratory distress. Stimulation of β-adrenergic receptors enhances alveolar fluid absorption. Therefore, the β2-adrenergic receptor agonist salbutamol has been proposed as a treatment for TTN. This study aims to evaluate the efficacy and safety of salbutamol as supportive pharmacotherapy together with non-invasive nasal continuous positive airway pressure (NIV/nCPAP) for the prevention of persistent pulmonary hypertension of the newborn (PPHN) in infants with TTN.Methods and analysisThis multicenter, double-blind, phase III trial will include infants with a gestational age between 32 and 42 weeks who are affected by respiratory disorders and treated in eight neonatal intensive care units in Poland. A total of 608 infants within 24 h after birth will be enrolled and randomly assigned (1:1) to receive nebulized salbutamol with NIV or ...
Medical Science Monitor, May 20, 2004
Klinische Padiatrie, Dec 13, 2022
Klinische Padiatrie, Nov 29, 2022
This is an open access article published by Thieme under the terms of the Creative Commons Attrib... more This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.
International Journal of Environmental Research and Public Health
Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a he... more Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a heel puncture for screening using the Newborn Pain Scale (NIPS), measure the heart rate and compare the effectiveness of non-pharmacological methods of pain control. Design: Randomized clinical trial. No experimental factors. The test was performed during routine screening. Surroundings: Provincial Specialist Hospital in Olsztyn. Patients/Participants: Pain was assessed in 90 full-term newborns. The newborns were rooming in with their mothers in the hospital. Interventions: Newborns were divided into three groups. Three different methods of pain relief were used: breastfeeding, 20% glucose administered orally and non-nutritional sucking. Main Outcome Measures: The primary pain outcome was measured using the NIPS and the secondary pain outcome measures (heart rate, oxygen saturation) were measured using a pulse oximeter. Results: During capillary blood sampling from the heel, most newborns,...
Journal of neonatal-perinatal medicine, Aug 16, 2023
Thrombosis Research, May 1, 2017
Fig. 1. The levels of MPs-TF (1A) and total TF (1B) in the cord blood of preterm infants (n = 23)... more Fig. 1. The levels of MPs-TF (1A) and total TF (1B) in the cord blood of preterm infants (n = 23) and term infants (n = 25).
Archives of Medical Science, 2012
Introduction: Healthcare-associated infection is a common problem in patients from neonatal inten... more Introduction: Healthcare-associated infection is a common problem in patients from neonatal intensive care units and it is one of the leading causes of death in this group of patients. Healthcare-associated infections are associated with increases in mortality, morbidity, and prolonged length of hospital stay. The aim of the study was to assess the incidence, clinical presentation, mortality and aetiology of healthcare-associated infections in newborns in a neonatal intensive care unit between 2005 and 2010. Material and methods: The research involved documentation of 2610 neonates hospitalized in this period in the Neonatal Intensive Care Unit, Dr Jan Biziel University Hospital No. 2 in Bydgoszcz. The incidence, clinical presentation, mortality and causative factors of healthcare-associated infections were assessed. Results: The prevalence of healthcare-associated infections was 7.32%. The most frequent healthcare-associated infections were bloodstream infection (65.4%) and urinary tract infection (22.5%). The mortality rate was 2.1%. The most frequent pathogens were coagulase-negative staphylococci (36.1%) and Klebsiella pneumoniae (29.3%). Conclusions: The rate of healthcare-associated bloodstream infections in the analysed department is low, taking into consideration the specificity of the department. There is a necessity to establish convenient definitions of various kinds of healthcare-associated infecions in neonates, especially those born preterm.
Medical Science Monitor, May 20, 2004
ABSTRACT Med Sci Monit, 2004; 10(Suppl 2): 112-114 112 BACKGROUND Aplasia cutis congenita (ACC) i... more ABSTRACT Med Sci Monit, 2004; 10(Suppl 2): 112-114 112 BACKGROUND Aplasia cutis congenita (ACC) is a rare disorder affecting 1–2 infants in every 10 000 births [1,2], characterized by the localized absence of all skin layers. The defect may also involve deeper tissues such as muscle and bone, often extending to the dura mater when the scalp is involved. The lesion is usually well demarcated, ulcerat-ed, and often presents as a translucent membrane beneath which underlying structures and vasculature can easily be visualized. The defect may also heal in utero, presenting as an atrophic scar at birth [3]. The majority of cases affect the scalp, but involvement of the trunk and extremities has been described. The disease may be isolated or associated with anom-alies of eyes, ear-nose-neck and limbs, developmental defects of the cardiovascular, gastrointestinal, genitouri-nary and central nervous systems, and malformation syndromes such as chromosomal abnormalities, Adams-Oliver syndrome, Bart's syndrome. Histological examination demonstrates a congenital absence of all skin layers, which are replaced by a layer of thin compact dermal collagen without overlying epithelium or adnexal structures. The most common complication related to this disorder are infection, haemorrhage, and, in defects localized on the vertex, meningitis and bleeding from the sagittal sinus. Therefore, when the defect is large, it is important to ensure a proper skin repair in order to avoid complica-tions and to prevent problems with thermoregulation and fluid balance. Healing of small size defects occurs with gradual epithelization from the margins, while a large loss of substance represents a major challenge, as healing can be slow and difficult as the aesthetic sequel can represent a relevant problem for the future of the patient. This case describes an otherwise healthy infant born of an initially twin gestation with a truncal and scalp cutis aplasia defect in an infant. CASE STUDY A 3500 g boy was born to a 27-year-old, insulin-depen-dent gestational diabetic woman who had received good prenatal care. The boy was born at 40 weeks' gestation by vaginal delivery and had an Apgar score of 8. The pregnancy was complicated by the death of a twin in the 16 th week of gestation. At birth, the boy was noted to have large skin defects on both sides of the abdominal wall (Figure 1), single lesion on the scalp (Figure 2) and two small defects on the both scapula region (Figure 3). Summary Background: Aplasia cutis congenital (ACC) is a rare group of disorders characterized by the focal absence of the skin recognized at birth.
Pediatria polska, Mar 1, 2012
STRESZCZENIE Wprowadzenie. Dane dostÚpne w piĂmiennictwie wskazujÈ, ĝe w zapobieganiu martwiczemu... more STRESZCZENIE Wprowadzenie. Dane dostÚpne w piĂmiennictwie wskazujÈ, ĝe w zapobieganiu martwiczemu zapaleniu jelit (NEC) pomocne mogÈ byÊ probiotyki. SkutecznoĂÊ kaĝdego szczepu probiotycznego musi byÊ oceniania oddzielnie. Cel. Ocena skutecznoĂci Lactobacillus rhamnosus ATC A07FA (L. rhamnosus), w porównaniu z placebo, w zapobieganiu NEC t2. stopnia wg Bella u wczeĂniaków z bardzo maïÈ urodzeniowÈ masÈ ciaïa. Metodyka. Przeprowadzono badanie z randomizacjÈ, metodÈ podwójnie Ălepej próby. WczeĂniaki speïniajÈce wszystkie kryteria wïÈczenia (wiek ciÈĝowy poniĝej 32. tygodnia, urodzeniowa masa ciaïa poniĝej 1500 g, czÚĂciowe lub caïkowite ĝywienie enteralne pokarmem matki) losowo przydzielano do jednej z 2 grup, w których otrzymywaïy L. rhamnosus (komerycyjnie dostÚpny jako preparat Lakcid) w dawce 1,2x10 10 jednostek tworzÈcych kolonie (n=30) albo placebo (n=25). InterwencjÚ rozpoczynano wraz z wprowadzeniem ĝywienia enteralnego, nie wczeĂniej niĝ w 7. dobie ĝycia, i stosowano przez caïy okres hospitalizacji. Gïównymi punktami koñcowymi byïy: NEC t2. stopnia wg Bella, posocznica oraz zgon. Wyniki. Badanie zostaïo ukoñczone przedwczeĂnie ze wzglÚdu na problemy z rekrutacjÈ. AnalizÈ objÚto dane doty-czÈce 55 wczeĂniaków. W grupie eksperymentalnej, w porównaniu z grupÈ kontrolnÈ, stwierdzono mniejsze ryzyko wystÈpienia NEC t2. stopnia wg Bella, ale róĝnica nie byïa istotna statystycznie (1/30; 3,3% versus 4/25; 16%, ryzyko wzglÚdne 0,2; 95% przedziaï ufnoĂci 0,02 do 1,75). W obu grupach stwierdzono podobne ryzyko posocznicy i zgonu. Nie stwierdzono istotnych statystycznie róĝnic pomiÚdzy grupami w zakresie wtórnych punktów koñcowych. Nie obserwowano dziaïañ niepoĝÈdanych. Wnioski. W chwili obecnej nie ma podstaw naukowych do stosowania L. rhamnosus ATC A07FA w zapobieganiu NEC u wczeĂniaków. Uzasadnione wydaje siÚ jednak przeprowadzenie badania z ww. szczepem, obejmujÈcego wiÚkszÈ liczbÚ wczeĂniaków.
Beneficial Microbes, Dec 1, 2014
A disseminated Lactobacillus rhamnosus GG ATCC 53103 infection was suspected in a 6 day-old newbo... more A disseminated Lactobacillus rhamnosus GG ATCC 53103 infection was suspected in a 6 day-old newborn with intrauterine growth restriction (IUGR) symptoms, treated empirically with antibiotics and given L. rhamnosus GG with the aim of preventing antibiotic-associated gastrointestinal complications. The level of C-reactive protein on day 5 compared with day 2 was increased in spite of negative urine and cerebrospinal fluid cultures. The blood sampled on day 6 was found to be positive for lactobacilli, and the isolate was pre-identified as L. rhamnosus or Lactobacillus casei on day 11. The strain identity was then verified as L. rhamnosus GG through PCR and 16S rRNA sequencing. Genotyping with the rep-PCR and AFLP methods confirmed the 100% genetic similarity for both the strain isolated from patient blood and the probiotic product. The newborn became touch-sensitive, cried a lot, had worsening laboratory test results, and increased inflammation parameters, but no fever was observed. After a further 9 days of antibiotic therapy, blood cultures became negative, and laboratory tests improved on day 25. The patient was discharged from the hospital after 27 days. IUGR with a possible link to L. rhamnosus GG bacteraemia might be a new potential risk group, beside patients with organ failure, immunocompromised status and dysfunctional gut barrier mechanisms, for which safe use of probiotics needs careful attention. Universally accepted or improved guidelines for the safer administration of probiotics in risk groups are urgently needed. This report should not discourage the use of probiotics, but should highlight the need for their careful use in IUGR patients.
Medical and Biological Sciences, 2012
Aim. Assessment of quality of life of children, adolescents and adults suffering from cystic fibr... more Aim. Assessment of quality of life of children, adolescents and adults suffering from cystic fibrosis and of their parents. Methods. Examination involved 23 persons (16 patients and 7 parents). Questionnaires CDQ-12-13, CFQ-14 and CFQ-6-13 were used as research tools. Results. Children between 12 and 13 years old, as well as young adults and adolescents ranked their physical aptitude and their food-related behaviours as highest, and the appearance of their bodies as lowest. Parents, on the other hand, assessed eating as a difficult effort for their children. A decisive majority of the parents claimed, that everyday therapy was time-consuming, yet fulfilling the therapy recommendations was not intensely difficult for the child. Also for adolescents and young adults, only minimally do the limitations resulting from a prolonged systematic therapy obstruct everyday life. Conclusion. The assessment of quality of life of children suffering from cystic fibrosis is varied. The highest patients' quality of life assessment is found in schoolchildren aged 12 to 13. Patients assess their body image as very poor.
PubMed, Apr 26, 2005
The aim of the study: Preliminary assessment of the incidence of acid gastroesophageal reflux in ... more The aim of the study: Preliminary assessment of the incidence of acid gastroesophageal reflux in preterm neonates with and without antenatal administration of steroids. Material and methods: Analysis of 96 neonates born before 34 weeks of pregnancy was undertaken. The patients were divided into two groups: I - those who received antenatal corticosteroids n=22; II - those who received no antenatal corticosteroids n=74. All patients had 24-hour pH-metry and basing on the result of this examination we diagnosed or excluded acid gastroesophageal reflux. Results: In group I gastroesophageal reflux was diagnosed in 9/22 neonates (40.9%), in group II in 12/72 (16.2%), odds ratio=3.58. Conclusions: The frequency of acid gastroesophageal reflux is higher in preterm infants who received antenatal corticosteroids.
Klinische Padiatrie, Dec 13, 2022
Medycyna wieku rozwojowego, Jul 1, 2005
Intrauterine growth retardation (IUGR) and prematurity are often correlated with higher mortality... more Intrauterine growth retardation (IUGR) and prematurity are often correlated with higher mortality and morbidity in the first days of life especially due to complications such as: hypoglycemia, polycythemia, necrotizing enterocolitis, meconium aspiration syndrome. Disturbances in the haemostatic system could be responsible for poor outcome of these complications. Aim: To determine the activity of main inhibitor of coagulation-antithrombin, level of protein C, concentration of thrombin-antithrombin (TAT) complexes and fibrinogen in the blood of premature infants with intrauterine growth retardation (IUGR) in comparison with premature infants without IUGR. Material: 33 premature infants with symptoms of intrauterine growth retardation (IUGR) and 146 premature infants without IUGR were included in our trial. Results: There were no statistical differences between the analyzed groups in the level of protein C, concentration of TAT and fibrinogen. Activity of antithrombin was higher within 1 hour after birth and lower on the third day of life in the group of children with IUGR. Conclusions: Higher activity of antithrombin after birth in the group of newborns with IUGR prevents excessive activation of coagulation. On the third or fourth day of life the activity of antithrombin decreases due to its higher consumption in the blood of newborns with IUGR.
Medycyna wieku rozwojowego, Jul 1, 2005
AIM OF THIS PAPER: To present the opinions of doctors and nurses on the limitations of resuscitat... more AIM OF THIS PAPER: To present the opinions of doctors and nurses on the limitations of resuscitation and treatment of extremely premature newborns. Material and methods: Anonymous questionnaire studies were carried out in 342 doctors and 1194 nurses from 6 provinces of Poland. The authors compared the answers of doctors and nurses as well as the answers form different provinces. The results were processed using the Chi2 test, with the significance level p<0.05. Results: The will to resuscitate the neonate, regardless of its birth weight was declared by 29% of the physicians and 49% of the nurses, regardless of the gestational age - by 21% of the physicians and 47% of the nurses. Resuscitation of an extremely immature, asphyctic newborn was declared by 71% of the physicians and 59% of the nurses. Limitation of therapy after diagnosing severe intracranial hemorrhage is declared by 67% of the physicians and 45% of the nurses. 37% of the doctors and 30% of the nurses would comply with parents' will when deciding about resuscitation. 44% of the physicians and 31% of the nurses declare taking parents' decision into account in the matter of abandoning resuscitation. Conclusions: 1. There is a higher percentage of persons convinced about the necessity of resuscitation of every newborn, regardless of its maturity, among the nurses than among the doctors. 2. Among the nurses there are more persons, who are sceptical about saving the extremely premature newborns born with asphyxia, whereas among the doctors there are more persons inclined to stop therapy in case of a severe intracranial hemorrhage. 3. The most controversial are problems concerning the consideration of parents' will in decision about whether to continue or abandon resuscitation, but physicians are more apt to regard parents' will in resuscitation in some situations. 4. The analysis of the questionnaire points to the need for deeper knowledge of the present mortality rates of the extremely immature newborns and further development of the surviving ones among the physicians and nurses.
Klinische Padiatrie, Nov 29, 2022
This is an open access article published by Thieme under the terms of the Creative Commons Attrib... more This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.
New England Journal of Medicine
Frontiers in Pediatrics
BackgroundTransient tachypnea of the newborn (TTN), which results from inadequate absorption of f... more BackgroundTransient tachypnea of the newborn (TTN), which results from inadequate absorption of fetal lung fluid, is the most common cause of neonatal respiratory distress. Stimulation of β-adrenergic receptors enhances alveolar fluid absorption. Therefore, the β2-adrenergic receptor agonist salbutamol has been proposed as a treatment for TTN. This study aims to evaluate the efficacy and safety of salbutamol as supportive pharmacotherapy together with non-invasive nasal continuous positive airway pressure (NIV/nCPAP) for the prevention of persistent pulmonary hypertension of the newborn (PPHN) in infants with TTN.Methods and analysisThis multicenter, double-blind, phase III trial will include infants with a gestational age between 32 and 42 weeks who are affected by respiratory disorders and treated in eight neonatal intensive care units in Poland. A total of 608 infants within 24 h after birth will be enrolled and randomly assigned (1:1) to receive nebulized salbutamol with NIV or ...
Medical Science Monitor, May 20, 2004
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Klinische Padiatrie, Nov 29, 2022
This is an open access article published by Thieme under the terms of the Creative Commons Attrib... more This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon.
International Journal of Environmental Research and Public Health
Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a he... more Aim: The aim of the study was to assess the severity of pain experienced by a newborn during a heel puncture for screening using the Newborn Pain Scale (NIPS), measure the heart rate and compare the effectiveness of non-pharmacological methods of pain control. Design: Randomized clinical trial. No experimental factors. The test was performed during routine screening. Surroundings: Provincial Specialist Hospital in Olsztyn. Patients/Participants: Pain was assessed in 90 full-term newborns. The newborns were rooming in with their mothers in the hospital. Interventions: Newborns were divided into three groups. Three different methods of pain relief were used: breastfeeding, 20% glucose administered orally and non-nutritional sucking. Main Outcome Measures: The primary pain outcome was measured using the NIPS and the secondary pain outcome measures (heart rate, oxygen saturation) were measured using a pulse oximeter. Results: During capillary blood sampling from the heel, most newborns,...